title: Routine trans-abdominal ultrasonography before laparoscopic sleeve gastrectomy: the findings.
abstract: Although some bariatric guidelines reserve pre-operative trans-abdominal ultrasonography screening for symptomatic patients and those with elevated liver enzymes, there has yet to exist a general consensus regarding this issue. Some centers still employ its use as a vital step in the workup of the bariatric patient. This study aims to observe the prevalent findings on routine pre-operative trans-abdominal ultrasonography when used as a screening tool prior to laparoscopic sleeve gastrectomy (LSG). All patients undergoing LSG were screened pre-operatively with trans-abdominal ultrasonography. A retrospective study was done of the pre-operative ultrasonography results of patients who underwent LSG at Amiri Hospital from 2008 to 2012. A total of 747 patients were included in the study, with a median age of 36 (15-68). Five hundred ninety (79.0 %) patients were females while 157 (21.0 %) were males, with an overall median body mass index (BMI) of 45 (30-90). Two hundred forty patients (32.1 %) had normal pre-operative ultrasonography results, 83 (11.1 %) were found to have gallstones, 427 (57.2 %) had fatty liver, and 55 (7.4 %) had other pathologies. There was no statistically significant association between BMI and gallstones (p = 0.545) and BMI and fatty liver (p = 0.418). Trans-abdominal ultrasonography screening prior to LSG revealed a wide range of findings but does not add significant information to the pre-operative workup of patients undergoing the procedure and should be reserved for indicated patients.
authors.affiliation: Department of Surgery, Amiri Hospital, Kuwait Ministry of Health, Kuwait City, Kuwait.
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Almazeedi
authors.forename: Salman
authors.initials: S
authors.lastname: Al-Sabah
authors.forename: Dheidan
authors.initials: D
authors.lastname: Alshammari
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000328:Adult; D015992:Body Mass Index; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging*; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008403:Mass Screening; D009767:Obesity, Morbid / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography; D015431:Weight Loss